tbuckley/cabot-search huggingface dataset:
Association of Medicaid expansion under the Affordable Care Act and overall survival among children with cancer.
Authors: Justin Michael Barnes, Corey Neff, Carol Kruchko, Jill Barnholtz-Sloan, Quinn T Ostrom, Kimberly J. Johnson
Journal: Journal of Clinical Oncology (2022)

6507 Background: State Medicaid expansions under the Affordable Care Act are associated with increased Medicaid coverage among children, including those with cancer. Since the expansions did not directly affect Medicaid eligibility criteria for children, these changes suggest “welcome mat” effects, where previously uninsured children become enrolled in Medicaid after their parents gain coverage. Insurance improvements from the expansions have been associated with improved cancer outcomes for non-elderly adults. However, it is unclear whether the expansions also impacted childhood cancer outcomes. Methods: Data for children ages 0-14 years diagnosed with cancer from 2011-2017 were queried from central cancer registries covering cancer diagnoses from 43 states as part of the Centers for Disease Control’s National Program of Cancer Registries. The primary outcome was 2-year overall survival. We utilized difference-in-differences analyses to compare changes in 2-year survival from 2011-2013 to 2014-2017 between children who resided in states expanding Medicaid by 2014 vs. states not expanding Medicaid within the study period. Analyses were adjusted for covariates including age, race/ethnicity, sex, metropolitan residence, cancer type, and stage at diagnosis. Results: A total of 42,970 children with cancer were included. Overall, there were increases in 2-year survival among children in expansion states (90.5% in 2011-2013 to 91.4% in 2014-2017) but no change among children in non-expansion states (90.0% in 2011-2013 to 90.0% in 2014-2017). In adjusted difference-in-differences analyses, there was no significant change in survival after Medicaid expansion for children in expansion vs. non-expansion states (1.01 percentage points, 95% CI = -0.23 to 2.25, p = 0.11). In difference-in-differences analyses by race/ethnicity, there was a significant expansion-associated improvement in survival in Black children (3.97 percentage points, 95% CI = 0.02 to 7.93, p = 0.049) but not in White children (0.4 percentage points, 95% CI = -1.07 to 2.04, p = 0.54). There were also expansion-associated improvements in survival among children residing in counties with the lowest quartile of county income (5.88 percentage points, 95% CI = 0.38 to 11.38, p = 0.036) but not for those in higher income counties (1.15, 1.23, and 0.12 percentage points for 2 nd , 3 rd , and 4 th quartiles, respectively). Conclusions: Medicaid expansion, through presumed increases in Medicaid coverage via welcome mat effects, was associated with increased 2-year survival for Black children and children residing in low-income counties. However, the concentration of Black children in states that have not expanded Medicaid highlights the need for further advocacy to more fully achieve improved outcomes. Future data are needed to clarify potential long-term impacts of Medicaid expansion on childhood cancer outcomes.
A phenotypic spectrum of autism is attributable to the combined effects of rare variants, polygenic risk and sex
Authors: Danny Antaki, James Guevara, Adam X. Maihofer, Marieke Klein, Madhusudan Gujral, Jakob Grove, Caitlin E. Carey, Oanh Hong, Maria J. Arranz, Amaia Hervas, Christina Corsello, Keith K. Vaux, Alysson R. Muotri, Lilia M. Iakoucheva, Eric Courchesne, Karen Pierce, Joseph G. Gleeson, Elise B. Robinson, Caroline M. Nievergelt, Jonathan Sebat
Journal: Nature Genetics (2022)
Prognostic role of neutrophil-to-lymphocyte ratio in patients with diffuse large B-cell lymphoma.
Authors: Luiza B. Kushtova, Elena M. Frantsiyants, Valeria A. Bandovkina, Yuliya Yu. Kozel, Viktoria V. Dmitrieva, Olga V. Kozyuk, Aleksandr V. Snezhko, Sergey A. Malinin, Lusegen Kh. Chalkhakhyan, Gennadiy V. Kaminskiy, Maksim N. Duritskiy, Petr N. Gabrichidze, Liubov Yu Vladimirova, Irina B. Lysenko, Nadezhda V. Nikolaeva, Oleg I. Kit
Journal: Journal of Clinical Oncology (2022)

e19560 Background: Diffuse large B-cell lymphoma (DLBCL) represents about 30-40% of all cases of non-Hodgkin lymphoma. The addition of rituximab to standard chemotherapy significantly improves survival, yet 30% of advanced-stage patients relapse. The International Prognostic Index (IPI) is used to evaluate the prognosis, but it cannot always accurately predict the outcome of therapy. The neutrophil-to-lymphocyte ratio (NLR) has recently been recognized as a prognostic factor in various types of solid tumors. The purpose of this study was to assess the prognostic value of NLR in DLBCL patients. Methods: Patients with DLBCL (n = 47) were recruited, including 31 patients in remission and 16 patients with relapsed DLBCL. All patients received 6-8 cycles of R-CHOP. Clinical parameters were studied, including IPI and complete blood count before treatment and after each chemotherapy cycle. Results: IPI predicted unfavorable outcome in 3 (18.75%) patients with relapses, and favorable outcome and high treatment efficacy in 13 (81.25%) patients. Among patients in remission, IPI predicted unfavorable outcome in 2 (6.5%) patients and favorable outcome in 29 (93.5%) patients. NLR calculation showed 100% low treatment efficacy for patients with relapses (NLR =4.1±0.51). At the same time, NLR predicted favorable outcome in 22 (70.96%) patients in remission (NLR =1.9±0.20), and relapses in 9 (29.04%) patients (NLR =4.83±0.55). 7 (22.6%) of the patients at risk developed relapses within 6-10 months after good treatment effects. Conclusions: Thus, NLR can be used as a prognostic factor in patients with DLBCL.
Decision-making and management strategies for patients with bilateral synchronous non-metastatic renal masses: Insights from a multi-centre European dataset
Authors: R. Campi, A. Pecoraro, M.C. Mir, D. Amparore, R. Bertolo, S. Erdem, O. Kara, A. Ingels, M.C. Kriegmair, I. Ouzaid, N. Pavan, A. Pecoraro, E. Russel, A. Minervini, S. Serni, T. Klatte, U. Capitanio
Journal: European Urology (2022)
Clinical performance of a liquid biopsy test based on the detection of multiple DNA methylation biomarkers for early detection of gastrointestinal cancers.
Authors: Yong Ma, Guodong Zhao, Kai Wang, Lishuang Song, Shangmin Xiong, Hui Li, Guangxia Chen, Bing Pei, Xizhong Shen, Sujuan Fei, Minxue Zheng
Journal: Journal of Clinical Oncology (2022)

e16096 Background: Gastrointestinal cancers (colorectal cancer, gastric cancer and esophageal cancer) are the most prevalent malignant tumors in China, resulting in 975,537 new cases and 958,675 deaths in 2020. Currently, the gold standard for the early detection of these cancers remains to be gastrointestinal endoscopy. However, the invasiveness, low throughput and high cost of these procedures have prevented its wide acceptance by Chinese population. The objective of this study was to develop a liquid biopsy test based on the detection of multiple DNA methylation biomarkers (SpecGastro test) and evaluate its clinical performance for early detection of gastrointestinal cancers. Methods: Two hundred and eighty-two gastrointestinal cancer patients (98 colorectal cancers, 136 gastric cancers and 48 esophageal cancers) and 195 control subjects were included. Ten milliliters of peripheral blood was drawn and 3.5 mL plasma was separated for cell-free DNA extraction and bisulfite conversion. The converted DNA was subsequently examined by SpecGastro test, a multiplex qPCR assay that detected six methylation biomarkers and one internal control. Results: Overall sensitivity for SpecGastro test was 76.6% (95% CI: 71.1-81.3%) with a specificity of 89.2% (95% CI: 83.8-93.1%). Sensitivities for colorectal cancer, gastric cancer and esophageal cancer were 87.8% (95% CI: 79.2-93.2%), 69.9% (95% CI: 61.3-77.3%) and 72.9% (95% CI: 57.9-84.3%), respectively. A high AUC of 0.903 (95% CI: 0.873-0.928) indicated that SpecGastro test distinguished gastrointestinal cancer patients from control subjects with high accuracy. Conclusions: Our analysis demonstrated the utility of SpecGastro test to detect three types of gastrointestinal cancers with high sensitivity and specificity. These results supported the feasibility of this blood-based SpecGastro test as a complementary tool to the existing single-cancer early detection tests.
Outcomes and complications in kidney transplantation from Donors after Circulatory Death (DCD): Differences between type II-uncontrolled and type III-controlled DCD
Authors: J. Medina Polo, R. Santos Pérez De La Blanca, E. Peña Vallejo, M. Hernández Arroyo, A. Rodríguez Antolín, M. Pamplona Casamayor, J.M. Duarte Ojeda, Á. Tejido Sánchez, N. Miranda Utrera, L. García González, A. Andrés Belmonte
Journal: European Urology (2022)
HGG-09. MicroRNAs expression profile in Meningioma 1 (MN1) gene altered astroblastoma
Authors: Manila Antonelli, Evelina Miele, Angela Mastronuzzi, Bianca Pollo, Maura Massimino, Marina Gardiman, Francesca Buttarelli, Simone Minasi, Felice Giangaspero, Francesca Gianno
Journal: Neuro-Oncology (2022)

Abstract Astroblastoma is a rare glial neoplasm arising more frequently in young, predominantly female, patients and with unclear clinical behavior and outcome. The diagnostic molecular alteration is the rearrangement of meningioma 1 (MN1) gene.However, little is known about the specific mechanism of tumor development driven by such genetic change. microRNAs (miRNAs) are important gene expression regulators with strong implications in several biological processes. In this study we investigated the microRNAs’ expression and regulation in MN1 altered neoplasms. We collected a cohort of 14 formalin-fixed, paraffin-embedded (FFPE) tumor samples histologically defined classified as astroblastoma. The DNA methylation analysis showed that only 8 cases harbored the MN1 rearrangement characteristic of astroblastoma. The 8 MN1 altered tumors were analyzed for their expression pattern of miRNAs by Nanostring technology. Thirty-nine deregulated miRNAs were found in the 8 astroblastomas compared to normal brain tissue. In order to understand the underlying mechanisms of the miRNAs aberrant expression, we first investigated the methylation status of themicroRNA promoters. Thirty-two out 39 deregulated miRNA resulted epigenetically regulated. with methylation status coherent with microRNA expression in 14/32 miRNAs.. Secondly, we investigated the hypothesis of a genomic alteration as a reason for the abnormal expression of the remaining 18/32 deregulated miRNAs by analyzing the Copy Number Variation (CNV) of tumor samples. but no alteration was found on miRNAs chromosome loci. Finally, we identified validated targets of the 32 deregulated miRNAs and uncovered biological processes putatively correlated to miRNA target genes, clinically and pathologically relevant in MN1-altered astroblastomas. Our findings shed light on the biology of this rare disease with potential implications on prognostic markers and therapy.
Population level impact of the NHS Diabetes Prevention Programme on incidence of type 2 diabetes in England: An observational study
Authors: Emma McManus, Rachel Meacock, Beth Parkinson, Matt Sutton
Journal: The Lancet Regional Health - Europe (2022)

The NHS Diabetes Prevention Programme (DPP) is the first nationwide type 2 diabetes prevention programme targeting people with prediabetes. It was rolled out across England from 2016 in three waves. We evaluate the population level impact of the NHS DPP on incidence rates of type 2 diabetes.We use data from the National Diabetes Audit, which records all individuals across England who have been diagnosed with type 2 diabetes by 2019. We use difference-in-differences regression models to estimate the impact of the phased introduction of the DPP on type 2 diabetes incidence. We compare patients registered with the 3,282 general practices enrolled from 2016 (wave 1) and the 1,610 practices enrolled from 2017 (wave 2) to those registered with the 1,584 practices enrolled from 2018 (final wave).Incidence rates of type 2 diabetes in wave 1 practices in 2018 and 2019 were significantly lower than would have been expected in the absence of the DPP (difference-in-differences Incident Rate Ratio (IRR) = 0·938 (95% CI 0·905 to 0·972)). Incidence rates were also significantly lower than expected for wave 2 practices in 2019 (difference-in-differences IRR = 0·927 (95% CI 0·885 to 0·972)). These results remained consistent across several robustness checks.Introduction of the NHS DPP reduced population incidence of type 2 diabetes. Longer follow-up is required to explore whether these effects are maintained or if diabetes onset is delayed.This research was funded by the National Institute for Health and Care Research (Health Services and Delivery Research, 16/48/07 - Evaluating the NHS Diabetes Prevention Programme (NHS DPP): the DIPLOMA research programme (Diabetes Prevention - Long Term Multimethod Assessment)). The views and opinions expressed in this manuscript are those of the authors and do not necessarily reflect those of the NHS, the National Institute for Health and Care Research or the Department of Health and Social Care.
Adagrasib Response Remains Strong in NSCLC
Journal: Cancer Discovery (2022)

In the phase II KRYSTAL-1 trial, the KRASG12C inhibitor adagrasib yielded an overall response rate of 43% and a disease control rate of 80% in patients with previously treated KRASG12C-mutant non-small cell lung cancer. After a median follow up of 12.9 months, overall survival was 11.7 months. The drug also shrank brain metastases in 33% of patients who had them.
Development of memorial Sloan Kettering (MSK) surgery stress score for older adults with cancer.
Authors: Armin Shahrokni, Amy L. Tin, Robert J. Downey, Bernard H. Bochner, Garrett Michael Nash, Soo Jung Kim, Anoushka Afonso, Beatriz Korc-Grodzicki, Andrew Vickers
Journal: Journal of Clinical Oncology (2022)

e24014 Background: The stress from oncologic surgeries for older adults may lead to poor surgical outcomes. In this study, we aim to develop a MSK Surgery Stress Score to measure the complexity of surgery for these patients. The score could then be used for future analyses using datasets where patients undergoing a variety of procedures. Methods: This is a retrospective analysis of adults aged 75 and older who underwent elective cancer surgery in our institution with hospital length of stay of at least one day in 2015 to 2020. Based on surgery stress score developed by Haga et al., we explored various models including at least one or some of these variables as linear or non-linear terms: operation time, weight (kg), blood loss (cc), type of surgery, body mass index, and incision score. The primary outcome of interest evaluated was defined as the composite outcome of death within 90-day of surgery, readmission or emergency room visit or major complications (grade 3-5) within 30 days of surgery. We additionally explored models for a secondary outcome, where minor complications (grade 1-2) were included in the definition, and lastly, we looked at major complications alone as a tertiary outcome. For each of the model and outcomes, we used a logistic regression. We then used the logit transformation of the predicted probability to represent the proposed surgery stress score. Using this score, we evaluated the area under the curve (AUC) for each outcome. Results: In total, 1573 patients were included in the study. The median age was 80 (quartiles 77, 83) and just under half (49%) were male. The median (quartile) operation time was 181 minutes (115, 259), weight was 71 kg (62, 84), blood loss was 100 mL (50, 300), and just over (51%) of patient underwent an abdominopelvic procedure. The rate of 90-day mortality was 3.8%, while the rate of 30-day major complication, readmission and emergency room visit was 7.4%, 10% and 13%, respectively Furthermore, 21%, and 35% experienced primary, and secondary outcomes, respectively. Overall, 18 predictive models for each of the outcomes were developed and assessed. AUC for our different models ranged from 0.59 to 0.73 for the different definitions of our outcomes. Among the various models, the one defined using whether patients underwent an abdominopelvic procedure, incision score, operation time, weight, and blood loss (the latter two both included as non-linear terms) appeared to the front runner. Conclusions: We explored potential models to be used as the MSK Surgery Stress Score. Currently the model is being optimized by additional work. Following optimization of the model, future studies should validate this score in other cohorts of older surgical patients with cancer.
Reply to Francesco Montorsi, Armando Stabile, Elio Mazzone, Giorgio Gandaglia, and Alberto Briganti’s Letter to the Editor re: Deepika Reddy, Max Peters, Taimur T. Shah, et al. Cancer Control Outcomes Following Focal Therapy Using High-intensity Focused Ultrasound in 1379 Men with Nonmetastatic Prostate Cancer: A Multi-institute 15-year Experience. Eur Urol 2022;81:407–13
Authors: Deepika Reddy, Hashim U. Ahmed
Journal: European Urology (2022)
Awareness of the link between HPV, cervical cancer, and HPV vaccination: An online survey among Polish women.
Authors: Artur Kotowski, Maja Dominika Kotowska, Aleksandra Zadroga, Katarzyna Hernas, Iwona Szymusik, Andrzej Mariusz Fal
Journal: Journal of Clinical Oncology (2022)

10538 Background: In 2019 cervical cancer (CC) was the 7th most common malignant neoplasm in Polish women. Its incidence has been declining over the years, nonetheless the 5-year survival rate is still significantly lower than the EU average. Vaccination against human papillomavirus (HPV) is not included in the mandatory immunization schedule in Poland and is not reimbursed yet. The aim of the study was to assess women's awareness of the risk factors of CC (including the role of HPV) and the possibility of cancer prevention through HPV vaccination. Methods: The questionnaire prepared by the study team was aimed at women and conducted online using social network sites. The single/multiple-choice questions included knowledge about CC, HPV and HPV vaccination. Statistical analyses were performed using MS Excel 2016 and Medistica pvalue.io 2021 software in general population and age- dependent subgroups. Results: The total number of 3262 women participated in the study. The age subgroups were: aged ≤ 18 years (group 1): 1090 (33.4%), aged 19-25 years (group 2): 1615 (49.5%) and &gt; 25 years (group 3): 557 (17.1%). Overall 81.4% of the respondents correctly associated HPV as the key factor of CC, 85.0% believed that CC could be prevented and 80.0% had heard of HPV vaccination before. In the last two parameters a statistically significant difference in age subgroups was observed (p &lt; 0.001). Only 21.2% of the total number of respondents were vaccinated (26.2%, 22.0% and 9.2% in age groups 1, 2 and 3 respectively, p &lt; 0.001). In all studied populations the following factors had the greatest influence on the decision to get vaccinated: parents’ advice – 54.8%, pediatrician recommendation – 15.7%, possibility of free vaccination offered by municipality – 11.6%, teachers’ advice - 9.7%, gynecologist recommendation - 8.2%. The main reasons behind not getting vaccinated were: high price (63.0%) and disbelief in efficacy (41.5%); only 12.2% respondents were afraid of possible side effects. 65.0% of the unvaccinated respondents declared willingness to get vaccinated in the future (71.5%, 66.1% and 52.0% in age groups 1, 2 and 3 respectively p &lt; 0.001), 28.5% of the respondents were not confident of their decision at the time of submitting answers. Conclusions: As oncogenic types of human papillomavirus play a vital role in pathogenesis of CC, the HPV vaccination and cytological screening together with awareness-raising campaigns should be considered the best strategy for the prevention of CC, its early detection and increase in survival rates. Vaccine willingness remains at high level especially among young women, however the effectiveness of vaccination should be emphasized and the HPV free vaccination programs should be introduced by the state. The educational role of gynecologists needs to be enhanced.
COVID-19 vaccination status and clinical outcomes in solid cancer patients treated with immune checkpoint inhibitors.
Authors: Karam Khaddour, Natalie Meeder, Josette Mary Kamel, Amaara Babwah, Ryan Huu-Tuan Nguyen, Heidy Wang, Li C. Liu, Lawrence Eric Feldman, Shikha Jain, Frank Weinberg
Journal: Journal of Clinical Oncology (2022)

e18731 Background: Immune checkpoint inhibitors (ICI) constitute the mainstay of treatment in several unresectable locally advanced and metastatic solid cancers. mRNA COVID-19 vaccines are immunogenic and can modulate intrinsic host immunostimulatory properties however the effect of COVID-19 mRNA vaccination on outcomes in patients receiving ICI is not well understood. This study examines the outcomes in cancer patients receiving ICI according to their vaccination status. Methods: From January 2021 to December 2021, we identified adult patients with locally advanced and metastatic solid tumors at the University of Illinois Hospital &amp; Health Sciences System who had received at least one dose of ICI, either as monotherapy or in combination with chemotherapy or targeted therapy, in any line of cancer treatment. Patients were stratified by COVID-19 vaccination status and treatment type (monotherapy versus combined chemoimmunotherapy). Endpoints included immune-related adverse events (IRAEs), progression-free survival (PFS) from ICI initiation and overall survival (OS). Results: Among 89 patients meeting these inclusion criteria, the mean age at diagnosis was 66 years, patient sex was about equally split (female 50.5% to male 49.5%), most patients were minorities (including 58.4% African American), vaccinated (78.7%), had lung cancer (57.3%), were stage IV (71.1%), and had received ICI monotherapy (67.4%). There were no significant differences in the rate of IRAEs between vaccinated and non-vaccinated patients ( p= 0.53). Patients who received ICI monotherapy had higher rates of IRAEs ( p&lt; 0.001). There was no difference in PFS between vaccinated and non-vaccinated patients ( p= 0.7) and no difference in OS between vaccinated and non-vaccinated patients ( p= 0.59). Conclusions: In this real-world sample of patients with advanced solid cancers who received ICI there were no significant differences in IRAEs, PFS or OS between vaccinated and non-vaccinated patients, which may be due to the relatively small sample size. Larger real-world datasets with long-term follow-up are needed to study the effect of mRNA COVID-19 vaccination on outcomes in advanced cancer patients receiving ICI.